Health Equity and Innovation Are at Risk for All of Us

The rapid development of COVID-19 vaccines illustrates what’s possible when federal policy fosters innovation with a real public-private partnership, especially for the health challenges facing America’s more than 54 million older adults. Yet, a number of drug-pricing policy proposals now jeopardize this very model, threatening to limit access to prescription drugs, compromise health equity and slow progress on urgently needed new treatments for age-related chronic conditions.

Rather than build on the lessons of COVID-19, Washington seems to be trying to rewrite them — and our aging population can ill afford the unintended consequences. If we are worried about the fiscal sustainability of Medicare, let’s be honest about the problem: a program created nearly 60 years ago when we had neither a fraction of the elderly we have today nor the medicines, therapies, treatments, diagnostics and digital health now available. Demand is simply outpacing the ability of Medicare to cope. Pretending that reducing drug prices is the answer is nothing less than public policy malpractice.

Instead, finding new solutions for healthy aging is vitally important as we enter an era defined by longevity — when most health needs arise — and by a society with more old than young. Paying for and investing in innovation, including biomedical miracles, is the only way to mitigate the fast-growing health and economic toll of complex, chronic conditions of aging.

Currently, more than 80 percent of Medicare beneficiaries are managing at least one chronic condition, such as Alzheimer’s disease, heart failure, osteoporosis and diseases that impair vision. Additionally, there are a number of seniors still managing HIV who depend on effective and innovative treatments to manage their health. Current proposals would have an adverse effect on future innovations in HIV that are critical for disease management and our efforts to end the HIV epidemic. Health policy must stimulate innovation to meet this need while improving healthcare equity and addressing access challenges.

But what’s on the table just doesn’t work. Congress is currently considering a number of proposals that would give the government unprecedented power to negotiate the prices of certain prescription drugs. But a majority of the seniors who actually rely on the Medicare Part D prescription drug program have said they are concerned that these proposals could limit their ability to choose and access the medications they need to manage chronic diseases.

Price-setting proposals would also undercut new innovations to better control and prevent these diseases, reduce long-term costs and enable healthier aging. Even in a limited form, these proposals could remove companies’ incentive to invest in continued research and development efforts on behalf of patients. The Congressional Budget Office estimates that pricing reforms — with drug negotiation elements similar to H.R. 3 — would lead to fewer new drugs, slowing innovation when we need it most.

There’s a better way, and the innovation experiences of COVID-19 offer a clear case in point. Instead of rushing ahead with misguided policies that could harm those they intend to protect, lawmakers should support solutions that will foster a hospitable and dynamic environment for innovation in biomedical research. This is especially critical as our country and communities confront the difficult health challenges that come with modern longevity and population aging. The current proposals would stifle the innovative solutions that could serve to bend the otherwise unsustainable rise in health costs — not the drugs, but hospital stays, doctor visits and other health costs, which are themselves mitigated by biomedical innovation.

In addition, Congress should support health policies that directly address socioeconomic barriers to care, improve health equity and ensure treatment access for patients of all ages and backgrounds. Capping Medicare Part D annual out-of-pocket costs at $2,000 is interesting. But it fails to do what is advertised when combined with negotiation tactics that disregard the time, resources and expenses that go into creating new and more effective treatments that will help patients, caregivers and families across the country.

The COVID-19 pandemic illustrated just how quickly the pharmaceutical industry can develop incredibly effective therapeutics and vaccines, as well as other innovation support in areas such as digital health. But we need supportive public policies, which can then become the basis to apply the equity lens, so these miracle solutions are scaled across all societies. Rather than flipping our entire system for health innovation on its head as we emerge from the pandemic, federal policymakers should strengthen the system that continues to bring life-saving cures to all Americans and address existing health disparities. Health equity and ongoing biomedical innovation are profoundly dependent on each other and must be treated as such.

Together, we can create a system that is both more innovative and more patient-centered, accessible and equitable to support healthy aging. And while doing this, we might even find ways to enable Medicare’s 21st-century sustainability rather than the certainty that current proposals will, paradoxically, lead to its unraveling.

Source: Morning Consult

Latest Developments

We keep our members and partners in touch with the most recent updates and opinions in the worldwide dialogue on population longevity and related issues.

Global Coalition on Aging Workshop Calls on G7 Countries to Fund Pull Incentives to Spur Antibiotic Innovation

The Global Coalition on Aging, in partnership with JPMA, today announced the release of its workshop report on the AMR crisis facing G7 countries and the world, “The Value of Pull Incentives in Japan to Encourage Investment in Antibiotic Innovation to Solve the AMR Crisis.” If strong action is not taken to address AMR, we will lose the antibiotics we need to cure infections, which is likely to outpace cancer as a major cause of death, killing an estimated 10 million by 2050.

Our National Conversation on Aging

Now that President Biden officially declared his run for a second term, what are we to make of the countless warnings about his age? Clearly, voters have already considered age a major factor – Google Search results for ‘Biden age’ hit an all-time-high just before the 2020 election – and speculation has only heightened four years on. Unfortunately, these concerns are misguided and even dangerous because they conflate age with poor health and confuse ideas about work and retirement.

World Immunization Week: Best-Kept Secret for 21st-Century Healthy Aging

The tremendous success of childhood immunisation campaigns across the 20thcentury is one of the greatest triumphs of public health. Along with advances in sanitation and antibiotics, childhood immunisation has resulted in the miracle of modern longevity: the once extravagant prospect of growing old has become the norm. Now, in our 21st century, isn’t it our great challenge to build on this achievement by realising a healthy longevity?

South China Morning Post Letter to the Editor

Antimicrobial resistance is one of the defining global problems of our time. Drug-resistant bacterial infections killed an estimated 1.27 million people in 2019. By 2050, 10 million lives annually could be lost to antimicrobial resistance, and annual global gross domestic product could fall by between 1.1 per cent and 3.8 per cent. Fortunately, Chinese policymakers, physicians and patients have shown what is possible when they focus collective efforts on antimicrobial resistance.

Medicine Price Setting Might Appeal to Voters but Will Cost Patients

As policymakers search for potential cuts to the national budget, they risk jeopardizing the country’s most cost-effective use of healthcare dollars: biomedical innovation regarding vaccines , prescription drugs, and emerging therapies, including antibodies. As the nation rapidly ages, protecting this pipeline of medicine will not only improve health outcomes but will do so at a lower cost by reducing more expensive hospital and primary care.

Global Coalition on Aging Hosts Cross-Sector Roundtable to Tackle Heart Valve Disease in Aging Societies

The Global Coalition on Aging (GCOA) and the Global Heart Hub have released a global position paper “Heart Valve Disease: Harnessing Innovation to Save Lives, Mitigate Costs, and Advance the Healthy Aging Agenda.” The report builds upon on a December 2022 GCOA-GHH roundtable of cross-sector experts and examines how behavior and policy change can best address heart valve disease in our 21st century.

New York City Twins with Ireland to Develop Age Friendly Communities

The twinning commits both sides to share knowledge on age friendly programs and builds on the 2011 Dublin Declaration of Age-Friendly Cities and Communities. The agreement was signed by the Cathaoirleach (Mayor) Nick Killian of Meath County Council which hosts the Irish Age Friendly Programme and Lorraine Cortés-Vázquez, Commissioner for Aging.

Just Getting Started at 75

In the latest charge against the promise of healthy aging, Dr. Ezekiel Emanuel, oncologist and bioethicist, doubled down on his infamous 2014 essay stating that 75 is the ideal age to die. Now 65, he maintains that after age 75, he will no longer receive medical screenings and interventions like colonoscopies, cancer treatment, flu shots, and heart valve replacement.